NPI | 1952942500 |
---|---|
Entity Type | Organization |
Authorized Contact | VANESSA FUENTES Billing Manager 323-268-9191 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2019-10-04 |
Last Update Date | 2020-10-23 |